What is spinal stenosis?
Spinal stenosis is a unique cause of back pain caused by narrowing of the spinal canal. The narrowing can be congenital, meaning that one was born with it. Commonly the narrowing is due to arthritis, or degeneration. Degeneration causes disc herniation and joint enlargement, both of which narrow the spinal canal.
What are the symptoms of spinal stenosis?
Patients suffering from spinal stenosis complain of pain radiating to one or both legs while walking or standing upright. The pain usually improves after sitting or leaning forward. Leaning back may make the pain worse. The reason for this fluctuation is that an upright posture, such as standing or walking, narrows an already narrowed spine. Leaning forward or taking a flexed posture, such as sitting, makes the degenerated spinal canal bigger, bringing relief.
What causes spinal stenosis?
Narrowing of the spinal canal is usually caused by degeneration of the spine. This degeneration is the result of bulging of the disc joints, bony growth of the facet joints or overgrowth of the ligaments of the spine.
How is spinal stenosis evaluated?
The first step in the evaluation of spinal stenosis is a careful history and physical examination. In patients who continue to have symptoms despite therapy and medications an MRI of the lumbar spine is often helpful, identifying the region of the spine where the stenosis resulting in painful activities lies.
How is spinal stenosis treated?
Medications and therapy are the first line in the treatment of back pain. In patients that don’t respond a spinal pain management evaluation can be performed. In this highly specialized evaluation, we determine which spinal nerve is compressed by the stenosis and what the cause is. Spinal injections can bring relief and confirm the source of pain. Minimally invasive surgery is reserved only for cases that do not improve with spinal injections.
Spinal stenosis treatments
The following spinal injections can be used to treat spinal stenosis:
The following minimally invasive surgical procedures can be used to treat spinal stenosis:
